ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2025
In-hospital mortality among children and adults hospitalized with COVID-19 in Africa across pre-delta, delta, and omicron SARS-CoV-2 waves.
Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study examines in-hospital mortality among children and adults hospitalized with COVID-19 across the pre-Delta, Delta, and Omicron waves in the African region.
methodWe conducted a retrospective cohort study using individual-level data from 520,810 hospitalized children and adults in 13 African countries. Cox proportional hazards regression models were used to assess the impact of SARS-CoV-2 variants on in-hospital mortality.
findingsAmong children, the risk of in-hospital mortality was comparable between pre-Delta and Delta waves (aHR 1.02, 95% CI 0.77-1.35). In adults, mortality increased by 6% during Delta wave compared with pre-Delta wave (aHR 1.06, 95% CI 1.04-1.09). During Omicron wave, mortality risk decreased significantly by 42% in children (aHR 0.58, 95% CI 0.43-0.80) and 59% in adults (aHR 0.41, 95% CI 0.40-0.43) compared to the Delta wave. Notably, the reduction in mortality risk during the Omicron wave was less pronounced for children with severe or critical COVID-19, those co-infected with HIV, and adults co-infected with either HIV or tuberculosis.
conclusionDespite a general reduction in mortality risk during Omicron wave, persistently high mortality in specific high-risk groups underscores the importance of prioritizing booster vaccinations and intensified treatment for vulnerable populations as per WHO recommendations.
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